crossing96/oncoscreening huggingface dataset:
Rates of Secondary Bladder and Rectal Cancers After External Beam Radiation for Prostate Cancer According to Age and D'amico Risk Groups in A Contemporary Cohort.	BACKGROUND: External beam radiation therapy (EBRT) predisposes to radiation-induced bladder (BCa) and/or rectal cancer (RCa). This risk may have declined with modern radiation techniques. Moreover, it remains unclear whether the risk varies by age or D'Amico risk classification. MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients who were treated with either EBRT or radical prostatectomy (RP) for prostate cancer. Cumulative incidence plots and competing risks regression (CRR) models were fitted. Subgroup analyses were performed according to year of diagnosis (contemporary: 2012-2020 vs. historical: 2004-2011 cohorts), age (< 65 vs. ≥ 65) and D'Amico risk groups. RESULTS: Of 251,838, 110,239 (44%) underwent EBRT versus 141,599 RP (56%). Relative to RP patients, EBRT was associated with a two-fold higher 10-year incidence of secondary BCa (0.9 versus 1.9%, respectively). In multivariable CRR models, EBRT was associated with higher risk of BCa (HR: 1.5, 95% CI: 1.3-1.6, P < .001). Similarly, relative to RP, EBRT was also associated with two-fold higher 10-year incidence of secondary RCa (0.8 versus 1.5%, respectively). In multivariable CRR models, EBRT was associated with higher risk of RCa (HR: 1.4, 95% CI: 1.2-1.5, P < .001). In subgroup analyses, the 5-year EBRT-RP absolute difference in secondary RCa was lower in the contemporary cohort (0.2%) than in the historical cohort (0.5%), whereas no such reduction was observed for BCa. In subgroup analyses according to D'Amico risk groups and age, no clinically significant differences were recorded. CONCLUSION: EBRT is associated with higher risk of both BCa and RCa as compared to RP. In contemporary EBRT patients, secondary RCa rate is lower, but not BCa rate. D'Amico risk groups as well as age categories did not affect either secondary BCa or secondary RCa rates.	bladder
An evaluation of the tumor microenvironment through CALR, IL1R1, IFNB1, and IFNG to assess prognosis and immunotherapy response in bladder cancer patients.	Immunogenic cell death (ICD) is a type of cell death sparking adaptive immune responses that can reshape the tumor microenvironment. Exploring key ICD-related genes in bladder cancer (BLCA) could enhance personalized treatment. The Cancer Genome Atlas (TCGA) BLCA patients were divided into two ICD subtypes: ICD-high and ICD-low. High ICD expression linked to increased immune cell infiltration and longer survival, but with potentially suppressed immune function. The high ICD group responded better to PD1-targeted therapy. A risk-scoring model with four ICD-related genes (CALR, IL1R1, IFNB1, IFNG) was validated across TCGA, GEO datasets, and tissue samples, showing higher risk score correlated with weaker anti-tumor immune function, more tumor-promoting elements, lower immunotherapy response rates, and shorter patient survival. This study connects ICD-related genes to BLCA prognosis and immune infiltration, offering a vital tool for personalized treatment guidance.	bladder
T cell subsets of urine-derived lymphocytes (UDLs) serve as an indicator of TILs and reflect immunological sex differences in bladder cancer.	BACKGROUND: Bladder cancer is unique among visceral malignancies in that urine, which can be easily obtained, has prolonged contact with bladder tumors. Urinary biomarkers offer the potential to provide insight into the host and tumor immune microenvironment to guide therapeutic strategies. We evaluated the immune cellular composition of urine (urine-derived lymphocytes (UDLs)) versus tumor (tumor-infiltrating lymphocytes (TILs)). METHODS: We employed high-dimensional flow cytometry analyses on immune cells from tumors (TILs), urine (UDLs), and peripheral blood (peripheral blood mononuclear cells) among patients with bladder cancer. We performed multiplexed immunofluorescence (mIF) of matched tumors to provide spatial context to our findings, comparing deep/invasive and superficial/urine-facing regions of matched tumors. RESULTS: Our findings suggest that the CD4(+) and CD8(+) T cell subsets of UDLs characterized by flow cytometry had similar phenotypic profiles to those found in TILs (cell clusters quantified by multidimensional scaling and differentiation states). Results of mIF imaging with a panel of phenotypic and functional T cell markers suggested that UDLs reflected TILs in both superficial and deep tumor sections. We also found sex-dependent patterns in TILs and UDLs, indicating the male bladder cancer tumor microenvironment is enriched in exhausted CD4(+) and CD8(+) T cells, while the female bladder cancer microenvironment is enriched for activated T cells. CONCLUSIONS: Assessment of UDLs opens avenues of non-invasive biomarker development in clinical settings where bladder cancer TILs are hypothesized to predict clinical response. UDLs may also reflect sex-based differences in antitumor immunity.	bladder
Survival outcomes with enfortumab vedotin-containing regimens in metastatic urothelial carcinoma: A systematic review and meta-analysis.	BACKGROUND: Metastatic urothelial carcinoma remains a highly lethal disease, particularly following progression on platinum-based chemotherapy and immune checkpoint inhibitors. Enfortumab vedotin (EV), a nectin-4-targeted antibody-drug conjugate, has shown encouraging activity in this setting, both as monotherapy and in combination with other agents. METHODS: A systematic review and meta-analysis was conducted PubMed, Embase, and the Cochrane Library were searched till March 2025 for original studies reporting survival outcomes of EV-based therapy. Summary survival curves were generated from Kaplan-Meier curves for overall survival and progression-free survival, and median OS and PFS were calculated, along with pooled OS and PFS at different time points. Secondary endpoints included objective response rate (ORR) and incidence of grade ≥ 3 treatment-related adverse events (TRAEs). Subgroup analyses were performed by regimen type (monotherapy vs. combination) and study phase. RESULTS: 32 studies involving 3770 patients were included. The pooled median OS was 26.7 months with EV plus pembrolizumab and 14.9 months with EV monotherapy. Median PFS was 13.14 and 6.89 months, respectively. The overall pooled ORR was 49 % (95 % CI: 45-53 %), with EV plus pembrolizumab achieving an ORR of 68 % (95 % CI: 64-71 %). 88 % of patients experienced an AE of any grade, with rash, peripheral neuropathy, and fatigue being the most common toxicities. CONCLUSION: EV-containing regimens demonstrate robust survival benefits and high response rates in patients with metastatic urothelial carcinoma, especially when combined with immune checkpoint blockade. These results support EV's integration into treatment paradigms and highlight the need for confirmatory randomized trials and biomarker-driven strategies to optimize outcomes.	bladder
AI-driven and Traditional Radiomic Model for Predicting Muscle Invasion in Bladder Cancer via Multi-parametric Imaging: A Systematic Review and Meta-analysis.	RATIONALE AND OBJECTIVES: This study systematically evaluates the diagnostic performance of artificial intelligence (AI)-driven and conventional radiomics models in detecting muscle-invasive bladder cancer (MIBC) through meta-analytical approaches. Furthermore, it investigates their potential synergistic value with the Vesical Imaging-Reporting and Data System (VI-RADS) and assesses clinical translation prospects. METHODS: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a comprehensive systematic search of PubMed, Web of Science, Embase, and Cochrane Library databases up to May 13, 2025, and manually screened the references of included studies. The quality and risk of bias of the selected studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) and Radiomics Quality Score (RQS) tools. We pooled the area under the curve (AUC), sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and their 95% confidence intervals (95% CI). Additionally, meta-regression and subgroup analyses were performed to identify potential sources of heterogeneity. RESULTS: This meta-analysis incorporated 43 studies comprising 9624 patients. The majority of included studies demonstrated low risk of bias, with a mean RQS of 18.89. Pooled analysis yielded an AUC of 0.92 (95% CI: 0.89-0.94). The aggregate sensitivity and specificity were both 0.86 (95% CI: 0.84-0.87), with heterogeneity indices of I² = 43.58 and I² = 72.76, respectively. The PLR was 5.97 (95% CI: 5.28-6.75, I² = 64.04), while the NLR was 0.17 (95% CI: 0.15-0.19, I² = 37.68). The DOR reached 35.57 (95% CI: 29.76-42.51, I² = 99.92). Notably, all included studies exhibited significant heterogeneity (P < 0.1). Meta-regression and subgroup analyses identified several significant sources of heterogeneity, including: study center type (single-center vs. multi-center), sample size (<100 vs. ≥100 patients), dataset classification (training, validation, testing, or ungrouped), imaging modality (computed tomography [CT] vs. magnetic resonance imaging [MRI]), modeling algorithm (deep learning vs. machine learning vs. other), validation methodology (cross-validation vs. cohort validation), segmentation method (manual vs. [semi]automated), regional differences (China vs. other countries), and risk of bias (high vs. low vs. unclear). CONCLUSION: AI-driven and traditional radiomic models have exhibited robust diagnostic performance for MIBC. Nevertheless, substantial heterogeneity across studies necessitates validation through multinational, multicenter prospective cohort studies to establish external validity.	bladder
Systematic Review of the Definition of Cure and of Curative-intent Treatments in Early Bladder Cancer.	BACKGROUND AND OBJECTIVE: Current guidelines on bladder cancer lack consensus on which outcomes should be used to define cure, the optimal time point for measurement, and which treatments can be given with curative intent in early bladder cancer. Our aim was to determine the optimal definition of cure by assessing cure definitions used in non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC) studies. METHODS: We conducted a systematic literature review via Embase and Medline on July 10, 2024, to identify real-world evidence (RWE) studies published within the previous 5 yr reporting key effectiveness outcomes (time to recurrence [TTR], overall survival [OS], and recurrence-free survival [RFS]) of NMIBC and MIBC treatments. KEY FINDINGS AND LIMITATIONS: Among 83 publications included in the review, median TTR ranged from 10 to 89 mo across seven NMIBC studies, and from 6 to 19 mo across five MIBC studies. RFS was the first and second most commonly reported outcome among the NMIBC and MIBC publications, respectively. OS and RFS were commonly reported at 1, 2, and 5 yr among NMIBC studies, and at 3 and 5 yr among MIBC studies. Limitations include the use of RWE only, the 5-yr cut-off for the publications included, and the scarcity of relevant data. CONCLUSIONS AND CLINICAL IMPLICATIONS: According to the evidence reviewed, 5-yr RFS appears to be a suitable definition of cure in early bladder cancer. Consensus on this or another surrogate outcome for measurement of cure could support the development of clinical trial designs and inform decision-making in health care from both clinician-patient and reimbursement perspectives.	bladder
Concurrent Ferroptosis and Pyroptosis Induced by a Dual-Organelle-Targeted Type I/II AIE Photosensitizer for Bladder Cancer Immunotherapy.	The therapeutic efficacy and cell death modalities of photodynamic therapy (PDT) highly depend on reactive oxygen species (ROS) generation mediated by photosensitizers (PSs) and their subcellular localization. However, research exploring the potential mechanisms underlying ROS-induced ferroptosis and pyroptosis remains scarce. In this study, we develop a type I/II aggregation-induced emission photosensitizer (AIE PS), DFTBPPY (DY), that primarily accumulates in the endoplasmic reticulum (ER) and lipid droplets (LDs) to disrupt lipid homeostasis and induce concurrent cell death against bladder cancer. DY is selectively endocytosed by tumor cells and anchors in both ER and LDs. Upon laser irradiation, in situ DY can generate ROS to initiate oxidative stress and damage the functions of the ER and LDs. This disruption thereby initiates a lipid peroxidation-cascading cell death pathway involving ferroptosis, pyroptosis, and immunogenic cell death (ICD), leading to potent antitumor effects. Our findings demonstrate that DY, as a dual-organelle-targeted PS, enhances therapeutic outcomes by orchestrating concurrent cell death mechanisms, which represents a promising alternative therapeutic strategy and highlights the potential of lipid imbalance in concurrent cell death for bladder cancer.	bladder
Efficacy of Open-Ended Urinary Catheters in Preventing Catheter-Related Bladder Discomfort: A Randomized Controlled Trial.	OBJECTIVE: Catheter-related bladder discomfort (CRBD) is a common postoperative complication following urological procedures, causing significant distress and reducing patient satisfaction. Although pharmacological interventions have been investigated, a more definitive approach is warranted. This study evaluated whether an open-ended Foley catheter (OEFC) reduces the incidence and severity of CRBD compared with a conventional Foley catheter (FC). MATERIALS: In this exploratory, parallel-group, single-blind, randomized controlled trial conducted at Hiroshima University Hospital, 100 patients undergoing transurethral resection of a bladder tumor or robot-assisted surgery for renal, renal pelvic, or ureteral malignancies were randomized 1:1 to receive either an OEFC or a standard FC. The primary endpoint was the incidence of CRBD at 6 h postoperatively. Secondary endpoints included the incidence and severity of CRBD and urethral pain, and the frequency of pharmacological intervention at predefined postoperative time points. RESULTS: Ninety-four patients were included in the full analysis set (47 per group). At 6 h postoperatively, CRBD incidence was significantly lower in the OEFC group than in the FC group (42.6% vs. 68.1%; p = 0.012). The OEFC group consistently demonstrated reduced CRBD incidence and severity compared with the FC group during the first 6 h. Urethral pain scores and analgesic use were comparable between groups. Subgroup analyses indicated that the preventive effect of OEFC was particularly notable in non-transurethral resection of bladder tumor patients. CONCLUSIONS: OEFC placement represents a broadly applicable and effective strategy to reduce CRBD following urological surgery. Catheter tip design appears to play a pivotal role in CRBD prevention.	bladder
Multiparametric MRI Features of Plasmacytoid Urothelial Carcinoma of the Urinary Bladder.	OBJECTIVE: Plasmacytoid urothelial carcinoma (PUC) is a rare aggressive bladder cancer subtype with limited imaging data owing to its low incidence. This study aimed to report the characteristic features of PUC on multiparametric MRI (mpMRI). MATERIALS AND METHODS: We retrospectively analyzed 13 patients with histologically confirmed PUC who underwent preoperative mpMRI between January 2019 and August 2024. Two blinded radiologists independently assessed tumor size, morphology, signal intensity, apparent diffusion coefficient (ADC) values, dynamic contrast enhancement patterns, contrast enhancement features, and invasive characteristics. Vesical imaging-reporting and data system (VI-RADS) scores were recorded. Interobserver agreement was evaluated using the kappa statistic. RESULTS: PUC predominantly exhibited diffuse (6/13, 46.2%) or localized (5/13, 38.5%) bladder wall thickening. Diffuse thickening was often associated with a linitis plastica-like appearance. On high b-value diffusion-weighted imaging (DWI), eight and seven cases depending on readers (61.5% and 53.8%, respectively) showed mild hyperintensity or isointensity, with a mean ADC value of 1.1 × 10⁻³ mm²/s. Dynamic contrast-enhanced MRI revealed progressive and prolonged enhancement in 10 cases (76.9%). VI-RADS scores ≥ 4 were observed in 11 cases (84.6%). Histopathological analysis showed that tumors with progressive and prolonged enhancement contained myxoid stroma and some fibrous tissue. Interobserver agreement was excellent for most imaging features, except for good agreement on DWI signal intensity. CONCLUSION: PUC demonstrates notable mpMRI features, including localized or diffuse wall thickening (often with a linitis plastica-like appearance), muscle-invasive and advanced disease, progressive and prolonged enhancement patterns, and mild hyperintensity or isointensity on high b-value DWI. These features, which are potentially linked to the myxoid stromal composition of the tumor, suggest that mpMRI may serve as a noninvasive diagnostic tool for this aggressive malignancy. However, further studies with larger cohorts are required to confirm these findings.	bladder
Long-term Results from the LEA Randomized Trial: Extended Versus Standard Lymph Node Dissection in Patients with Bladder Cancer Undergoing Radical Cystectomy.	The extent of lymph node dissection (LND) at the time of radical cystectomy (RC) for bladder cancer (BC) may affect oncologic outcomes. We present updated long-term data from a prospective, multicenter, phase 3 trial involving patients with locally resectable, high-risk T1 grade 3 or muscle-invasive urothelial BC (T2-T4a M0) without neoadjuvant treatment (trial LEA AUO AB 25/02; NCT01215071). A total of 401 patients were randomly assigned 1:1 to either standard LND (sLND: obturator, internal, and external iliac nodes) or extended LND (eLND), which also included the deep obturator, common iliac, presacral, paracaval, interaortocaval, and para-aortic nodes up to the inferior mesenteric artery. Median follow-up for patients alive without disease recurrence was 58.4 mo. The primary endpoint was recurrence-free survival (RFS). Overall survival (OS) and cancer-specific survival (CSS) were secondary endpoints. eLND failed to show superiority over sLND for RFS (5-yr rate: 68% vs 60%; hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.56-1.14; p = 0.2) and OS (5-yr rate: 57% vs 51%; HR 0.84, 95% CI 0.64-1.12; p = 0.2). The CSS rate was significantly higher in the eLND arm (5-yr rate: 76% vs 65%; HR 0.65, 95% CI 0.43-0.96; p = 0.031), which is clinically meaningful. With long-term follow-up, this randomized controlled trial remains negative for the primary endpoint of RFS, but was positive for CSS. Therefore, meticulous LND using at least a standard template remains the recommended surgical approach for patients undergoing RC for BC.	bladder
[Recurrence of urothelial bladder cancer in the upper urinary tract after radical cystectomy: is there prevention and what are the treatment options?].	Radical cystectomy is recognized as the gold standard in the management of muscle-invasive bladder cancer. However, despite its definitive nature, recurrences of urothelial carcinoma in the upper urinary tract remain an important cause of morbidity and mortality during long-term follow-up. The prognosis of such recurrences is generally poor, largely due to delayed diagnosis. This article presents three clinical cases of upper urinary tract recurrence detected 16-24 months after radical cystectomy. Successful treatment was achieved with radical nephroureterectomy including excision of the adjacent intestinal segment. These cases highlight the effectiveness of this surgical approach for upper tract recurrences following radical cystectomy and emphasize the need to establish criteria to determine whether urothelial tumors in the upper urinary tract represent true recurrences of bladder cancer or previously undiagnosed primary lesions. Further studies are required to develop algorithms for the early detection and management of this relatively rare pattern of disease progression.	bladder
Single-cell RNA sequencing identifies potential critical prognostic biomarkers in bladder carcinoma.	To identify genetic markers that can predict the prognosis of bladder carcinoma (BC) patients using single-cell RNA sequencing (scRNA-seq). The RNA-seq data for BC were obtained from the GSA-Human database (HRA000212). Quality control and normalization were performed using the Seurat package, followed by identification of highly variable genes. Cell clustering and annotation were based on these genes. Functional enrichment analyses (GO and KEGG) were conducted, along with cell-cell communication and trajectory analysis. Prognostic modeling was performed using LASSO-Cox regression, with Receiver Operating Characteristic (ROC) analysis for risk group evaluation. Gene expression validation was carried out via RT-qPCR and western blotting in normal (SV-HUC-1) and BC cell lines (T24, J82, EJ, UM-UC-3, 5637, RT112). A total of 473 upregulated genes and 106 downregulated genes were identified in BC samples. These differentially expressed genes (DEGs) were significantly enriched in apoptosis-related signaling pathways and IL-17 signaling pathway. Cell-cell communication analysis suggested that the CXCL2/MIF-CXCR2 signaling pathway may mediate interactions between epithelial cells and fibroblasts. By integrating bulk RNA sequencing data, we identified 49 genes that are associated with the prognosis of BC. Using the LASSO-Cox regression model, 17 prognostic genes were selected. Stratification of patients into high- and low-risk groups based on these genes allowed for effective survival prediction, supported by the ROC curve analysis. Univariate and multivariate Cox regression analyses further confirmed that the risk score was an independent predictor of overall survival. Furthermore, IGFBP5, KRT14 and SERPINF1 were found to be linked to poor survival outcomes in BC, with their expression levels notably elevated in BC cell lines compared to a normal bladder cell line. This study identified potential prognostic marker genes for BC, offering valuable insights into the prediction of patient survival outcomes.	bladder
Bacillus Calmette-Guérin (BCG) in combination with PANVAC™ vs. BCG alone in adults with high-grade BCG-refractory non-muscle-invasive bladder cancer.	PURPOSE: We postulated that PANVAC™, a recombinant poxviral vector vaccine, could enhance the immunologic and clinical response to an additional induction course of bacillus Calmette-Guérin (BCG) in patients with recurrent high-grade non-muscle-invasive bladder cancer (NMIBC). METHODS: This was a randomized, open-label, prospective, phase II study in subjects with high-grade NMIBC who had failed at least 1 induction course of intravesical BCG. Patients were randomized to either BCG alone or BCG+PANVAC. All subjects received intravesical BCG for 6 weeks. Patients in the combination arm also received priming and booster doses of PANVAC. The primary endpoint was recurrence-free survival. Secondary endpoints included progression-free survival and radical cystectomy-free survival. We also evaluated exploratory secondary immunological response endpoints. RESULTS: Our study concluded based on preplanned futility analysis. Overall, 32 patients were enrolled; 2 withdrew. Thirty patients (15/arm) were analyzed; 5 (33.3%) in the BCG-alone arm and 5 (33.3%) in the BCG+PANVAC arm met criteria for BCG- unresponsive disease. 12-month recurrence-free survival was 53.3% for the BCG-alone arm and 40% for the BCG+PANVAC arm. Overall recurrence rate at any time point was 73.3% at a median of 10.8 months, for an overall recurrence rate of 66.7% in the BCG-alone arm and 80% in the BCG+PANVAC arm. There was no difference in median recurrence-free survival or progression-free survival. CONCLUSIONS: This phase II study demonstrated no improvement in recurrence-free survival with BCG+PANVAC compared to BCG alone in patients with NMIBC who failed to respond to intravesical BCG.	bladder